Abstract:

This paper summarizes the postoperative nursing experience of a child with primary hyperoxaluria type Ⅰ who underwent liver transplantation. The key nursing measures were as follows：precise a anticoagulation combined with multi-dimensional bleeding assessment to early warn the occurrence of occult bleeding；a refined volume management strategy was formulated to maintain circulatory stability and ensure adequate perfusion of the transplanted liver；implementing de-escalation renal replacement therapy to prevent oxalate intoxication and dialysis-related complications；adopting phased nutritional support to alleviate hyperoxalemia and treat chylous leakage；and conducting individualized follow-up management to optimize organ function and create favorable conditions for sequential kidney transplantation. With meticulous nursing interventions，the child recovered and was discharged from hospital. During a 90-day follow-up，the function of the transplanted liver remained stable；the child received regular hemodialysis；the urinary oxalate level decreased steadily；the child was enrolled in the waiting list for pediatric kidney transplantation.

Key words: Hyperoxaluria, Renal Failure, Liver Transplantation, Pediatric Nursing

摘要：

总结1例原发性Ⅰ型高草酸尿症患儿行肝移植的术后护理经验。护理要点：精准抗凝联合多维出血评估，预警隐匿性出血的发生；制订精细化容量管理方案，维持血流动力学稳定，保证移植肝有效灌注；降阶梯肾脏替代治疗，预防草酸中毒及透析并发症；实施分阶段营养支持，缓解高草酸血症，治疗乳糜漏；开展个体化随访管理，优化器官功能，为序贯肾移植创造条件。经过精心护理，53 d后患儿顺利出院，随访90 d，移植肝功能稳定，经规律血液透析，尿草酸含量稳步下降，进入儿童肾移植等待排序。

关键词: 高草酸尿症, 肾功能衰竭, 肝移植, 儿科护理学